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2012 Grants - Rapp
Validation of a Simulation-Based Assessment of Cognitive Functioning
Steve R. Rapp, Ph.D.
Wake Forest University Health Sciences
Winston-Salem, North Carolina
2012 Development of New Cognitive Functional Instrumentation in Alzheimer's Disease
Increasingly, researchers and clinicians are focused on earlier detection of neurodegenerative diseases such as Alzheimer's to elucidate the disease process and to design earlier interventions. Functional decline is often assessed by clinicians with nonstandardized questions to the individual or a proxy, which are subject to multiple biases and inaccuracies; standardized questionnaires assessing basic or instrumental activities of daily living, which can confound physical and cognitive difficulties the individual is having; or standardized interviews, which are time consuming. Therefore, early detection of subtle changes in cognition and behavior will require new assessment methods.
Steve R. Rapp, Ph.D., and colleagues have developed four computer-based simulations of cognitively demanding everyday tasks—matching faces with names, using an automated teller machine, refilling a medication prescription using an automated telephone system, and filling a weekly pillbox with three medications. Each simulation task has multiple subtasks, which are captured. The SIMulated Behavioral Assessment of Cognition (SIMBAC) system improves upon existing assessment tools by (a) more closely resembling actual behaviors, (b) offering more detailed characterization of performance, (c) avoiding rater or observer biases, and (d) reducing the burden and cost of assessment. For this research grant the investigators will validate SIMBAC in a large, well-characterized sample of older adults with differing degrees of cognitive impairment to assess sensitivity to change, to affirm its reliability and to document its acceptability to older users.